Dorsal metacarpal island flap in syndactyly treatment

Aydın, Atakan; Erer, Metin

doi:10.1016/s0363-5023(03)80365-9

Cited by 17 publications

(29 citation statements)

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“…High incidence of contractures and distal web creep after the use of skin graft in the web areas where the tissue is invariably deficient has led to the evolution of many operative procedures and dorsal local flaps of different designs to suit the requirements [1,4,8,10,11,14,15]. Zeller, in the year 1810, first described a dorsal 'V' flap to form the commisure, and Differbach, in 1834, used a quadrilateral flap for the same purpose [5].…”

Section: Discussionmentioning

confidence: 99%

“…Killiam et al, in 1985, further modified this method by placing the flap slightly ulnar and proximal to the volar flap [9]. In the last few decades, many authors have described perforator-based dorsal flaps of various designs for the web reconstruction [1,6,10,14,15]. The normal anatomy of the interdigital web space demonstrates a configuration like that of a 'V' which is wider distally and tapers off proximally and slopes at a 35-45°angle from the proximo-dorsal to disto-palmar (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…The separated fingers have a greater surface area than the syndactylized digits, so additional skin coverage is almost always needed in majority of cases [7]. Various reconstructive options like split-skin grafting, full-thickness graft, and local flaps have been described by various authors [1,4,8,10,11,14,15]. Traditionally, web creation has been done by use of flaps taken from the dorsum of the hand and proximal phalanx; the resultant donor defects have been managed by use of skin grafts.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

End-of-Skin Grafts in Syndactyly Release: Description of a New Flap for Web Space Resurfacing and Primary Closure of Finger Defects

Sharma

Tuli

Makkar

et al. 2008

Hand (New York, N,Y.)

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Treatment of syndactyly necessitates creation of neo-web space and separation of fingers. Traditionally, this has been done by use of flaps taken from the dorsum; the resultant raw areas thus created have been managed by use of skin grafts. The classical teaching has been that the separated fingers will need skin graft as primary closure is not possible. The skin grafts have a tendency to contract and lead to finger flexion contractures and "creep" of the web space. We describe a flap based upon subcutaneous tissue in the web that is moved in a V-Y fashion to resurface the neo-web. The flap donor site can easily be closed primarily. The fingers are then separated; the subcutaneous fat is carefully removed from the finger flaps under magnification to allow primary closure of the finger defects. It has been possible to primarily close the donor site and fingers in all the patients. The procedure has been used in seven patients with 14 web releases. The age varied between 10 months to 3 years. The V-Y advancement flap based upon the subcutaneous pedicle in the region of the web allows adequate creation of a new web space. The careful de-fattening of skin flaps allows the separated fingers to be closed primarily.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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End-of-Skin Grafts in Syndactyly Release: Description of a New Flap for Web Space Resurfacing and Primary Closure of Finger Defects

Sharma

Tuli

Makkar

et al. 2008

Hand (New York, N,Y.)

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“…Such defects may need flap coverage. Most flaps for syndactyly treatment are described for web-space reconstruction [6][7][8][9]. One report is seen in the literature for flap coverage of finger sides after separation of syndactylized digits [10].…”

Section: Introductionmentioning

confidence: 99%

Distally based venous flap: a new technique for the correction of syndactyly without skin graft in adult patients

2009

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Skin grafts and local flaps are conventional methods for repairing simple syndactyly. Skin grafts usually leave unsightly appearance and contracture formation. In this study, unipedicled distally based venous flap were raised from third or fourth metacarpal area of the hand for syndactyly treatment. The distally based venous flap was to provide skin coverage to one side of the finger, in order to avoid complications arising from using skin graft. Nine patients' syndactylies (5 simple incomplete and 4 simple complete syndactyly) were treated using this method. The mean follow-up period of the flaps was 14 months, ranging from 12 to 16 months. Mild edema and venous congestion occurred in all flaps. Superficial necrosis involving two flaps did not affect flap survival. All flaps survived completely. In this article, we have described a new surgical technique for the correction of syndactyly in a single surgical procedure that utilizes a distally based venous flap to provide skin coverage without skin graft.

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“…The method of using an islanded dorsal flap without additional skin grafts for syndactyly release was first described by Sherif et al in 1998 [8], being subsequently reported and modified by many authors [1,3,5,9,11]. While they all agree that this method of web space reconstruction provides an excellent basis for a long-lasting good result, most of them also admit that it is not suitable for all syndactyly types, and that releasing complete and complex syndactylies most often still requires the use of skin grafts and local flaps [3,5,9,11].…”

mentioning

confidence: 99%

Re: End-of-Skin Grafts in Syndactyly Release: Description of a New Flap for Web Space Resurfacing and Primary Closure of Finger Defects

Bulić

2012

Hand (New York, N,Y.)

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Dorsal metacarpal island flap in syndactyly treatment

Cited by 17 publications

References 0 publications

End-of-Skin Grafts in Syndactyly Release: Description of a New Flap for Web Space Resurfacing and Primary Closure of Finger Defects

End-of-Skin Grafts in Syndactyly Release: Description of a New Flap for Web Space Resurfacing and Primary Closure of Finger Defects

Distally based venous flap: a new technique for the correction of syndactyly without skin graft in adult patients

Re: End-of-Skin Grafts in Syndactyly Release: Description of a New Flap for Web Space Resurfacing and Primary Closure of Finger Defects

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